Loading employer…
Employer
222 Chestnut Street, Meadville, PA 16335 · EIN 25-1070244 · Jul 1, 2024 to Jun 30, 2025
Plan year 2024
View
Schedule A
Coverage contracts on the filing. If the carrier did not provide Schedule A, the row is listed with that note.
Visible subtotal $7,990
| Coverage | Carrier | Broker | Lives | Direct comp |
|---|---|---|---|---|
| Dental | Delta Dental Of Pennsylvania | — | — | Schedule A not provided |
| Vision | Vision Benefits Of America | Mfr. And Bus. Assoc. Ins. Agency | 112 | $199 9.0% of $2,208 |
| Vision | Vision Benefits Of America | The Dbj Group Inc | 112 | $44 2.0% of $2,208 |
| Life | Hartford Life And Accident | — | — | Schedule A not provided |
| Stop-loss | HM Life Insurance Company | — | 164 | Comp not disclosed Premium $77,749 |
| Stop-loss | HM Life Insurance Company | — | 169 | Comp not disclosed Premium $315,499 |
| Dental | Delta Dental Of Pennsylvania | The Dbj Group Inc | 137 | $4,624 9.0% of $51,379 |
| Dental | Delta Dental Of Pennsylvania | Manufacturer & Business Association | 137 | $771 1.5% of $51,379 |
| Vision | Vision Benefits Of America | The Dbj Group Inc | 111 | $806 9.0% of $8,932 |
| Vision | Vision Benefits Of America | Manufacturer & Bus. Assn. Insurance | 111 | $177 2.0% of $8,932 |
| Life | Hartford Life And Accident | Risk Placement Services Inc | 113 | $1,369 15.0% of $9,129 |
Schedule C
Plan-paid amounts to each named party on the filing, with the role they reported. This is not a carrier commission and is not added to Schedule A.
Visible subtotal $125,571
| Party | Type | Amount | $ / Enrolled / Year |
|---|---|---|---|
| The Benecon Group | Broker | $7,886 | $48.09 |
| Highmark West | Admin | $18,537 | $113.03 |
| ConnectCare3 | Patient Advocate | $2,735 | $16.68 |
| The Benecon Group | Broker | $44,752 | $264.80 |
| Highmark, Inc. | Admin | $51,661 | $305.69 |